The National Commission on Correctional Health Care (NCCHC) guidelines for alcohol detoxification for jail detainees encompass detection and treatment as well as data collection for improving the quality of efforts to address alcohol withdrawal syndrome (AWS).
The implementation of these guidelines for recognizing and treating AWS is critical, since AWS can progress to delirium tremens (DTs) and death, and AWS is prevalent among those entering holding centers and jails. The guidelines propose four essential components for addressing AWS. One component is universal screening for potential AWS symptoms upon entry into the facility. A second component is a medical evaluation using a standardized instrument. A third component is detoxification that includes treatment with medication. A fourth component is referral for substance abuse treatment following detoxification. Detailed guidance is provided for each of these components. The report's section on quality improvement measures suggests data needed for measuring the effectiveness of efforts to treat AWS. These include the measurement of percentages of new inmates who are screened for AWS upon entry; who are screened positive for AWS and are referred for medical evaluation; who screen positive for AWS risk and are seen by an appropriate health professional for medical evaluation within 2 hours of admission; and inmates who screen positive and are assessed for AWS using a formal scale. Data should also be maintained on the percentage of patients who are subsequently diagnosed with AWS but were not identified through screening or evaluation. Other data that should be collected include the percentage of new inmates with AWS who are referred for substance abuse treatment on release from the facility. Patient deaths from AWS should also be recorded. 1 table, 1 figure, and a listing of 12 resources